High-flavanol and high-theobromine versus low-flavanol and low-theobromine chocolate to improve uterine artery pulsatility index: a double blind randomized clinical trial

Bujold, Emmanuel; Leblanc, Valérie; Lavoie-Lebel, Élise; Babar, Asma; Girard, M. Fusco; Poungui, Lionel; Blanchet, Carole; Marc, Isabelle; Lemieux, Simone; Abdous, Belkacem; Sidi, Elhadji Laouan; Dodin, Sylvie

doi:10.1080/14767058.2016.1236250

Cited by 7 publications

(5 citation statements)

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“…5 The actual symptomatic treatment to preeclampsia is mainly composed of severity assessment, blood pressure management, seizure prophylaxis, and placenta delivery. 6 Soluble fms-like tyrosine kinase (sFlt-1) is an angiogenesisrelated factor, which participates in the vasculogenesis, angiogenesis, and arteriogenesis regulation and maintains the angiogenic balance in placenta development. 7 Increasing evidence has revealed the correlation between the upregulation of circulating sFlt-1 and the preeclampsia development, and sFlt-1 has been identified as a possible biomarker for the diagnosis and prevention for preeclampsia in clinic.…”

Section: ■ Introductionmentioning

confidence: 99%

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Nanoparticle-Mediated Simultaneous Downregulation of Placental Nrf2 and sFlt1 Improves Maternal and Fetal Outcomes in a Preeclampsia Mouse Model

Xue

et al. 2020

ACS Biomater. Sci. Eng.

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Preeclampsia has impacted 3−5% pregnancies among the world and its complications lead to both maternal and fetal morbidity and mortality. However, management of preeclampsia is limited. Nanoparticles targeting chondroitin sulfate A (CSA) can deliver drugs to placenta. Inactivation of soluble fmslike tyrosine kinase (sFlt-1) and nuclear factor-erythroid 2-like 2 (Nrf2) has been proved to alleviate preeclampsia and improve maternal and fetal outcomes. Carboxyl-polyethylene glycol-poly (D,L-lactide) (COOH-PEG5K-PLA8K), cationic lipid DOTAP, and siNrf2 and sisFlt-1 were used to construct the nanoparticles and conjugating peptides targeting CSA was fabricated to it. The expression levels of proteins and RNAs were estimated by qRT-PCR and Western blot assays. ELISA assays were performed to evaluate levels of circulating sFlt-1. The nanoparticles containing siNrf2 and sisFlt-1 are targeted to the placenta trophoblasts and downregulated the expression levels of Nrf2 and sFlt-1 as well as their downstream genes in the placental cells of model mice. Treatment of nanoparticles induced the expression of angiogenic factors in placenta. Knocking down Nrf2 and sFlt-1 synchronously alleviated the preeclampsia and increased the maternal and fetal outcomes in preeclampsia model mice. Nanoparticle-mediated simultaneous downregulation of placental Nrf2 and sFlt1 improved maternal and fetal outcomes in a preeclampsia mouse model.

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Section: ■ Introductionmentioning

confidence: 99%

“…However, the management strategies of preeclampsia are rather limited due to the complex pathogenesis and multisystemic symptoms of preeclampsia syndrome . The actual symptomatic treatment to preeclampsia is mainly composed of severity assessment, blood pressure management, seizure prophylaxis, and placenta delivery …”

Section: Introductionmentioning

confidence: 99%

Nanoparticle-Mediated Simultaneous Downregulation of Placental Nrf2 and sFlt1 Improves Maternal and Fetal Outcomes in a Preeclampsia Mouse Model

Xue

et al. 2020

ACS Biomater. Sci. Eng.

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“…Similarly, specific life stages, such as pregnancy, can also affect the bioactivity of phenolic compounds. For example, some clinical trials evaluating flavan-3-ol intake from berries and cocoa/chocolate products on health outcomes in pregnancy showed improvement in maternal weight gain, glycemic control, inflammation, and placental function (68)(69)(70).…”

Section: Summary Of Considerations For Special Populationsmentioning

confidence: 99%

Flavan-3-ols and Cardiometabolic Health: First Ever Dietary Bioactive Guideline

Crowe-White

Evans

Kuhnle

et al. 2022

Advances in Nutrition

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Guideline recommendation for a plant bioactive such as flavan-3-ols is a departure from previous recommendations as it is not based on deficiencies but rather improvement in health outcomes. Nevertheless, there is a rapidly growing body of clinical data reflecting benefits of flavan-3-ol intake that outweigh potential harms. Thus, the objective of the Expert Panel was to develop an intake recommendation for flavan-3-ols and cardiometabolic outcomes to inform multiple stakeholders including clinicians, policymakers, public health entities, and consumers. Guideline development followed the process set forth by the Academy of Nutrition and Dietetics which includes use of Evidence to Decision Framework. Studies informing this guideline (157 randomized controlled trials and 15 cohort studies) were previously reviewed in a recently published systematic review and meta-analysis. Quality and strength-of-evidence along with risk-of-bias in reporting was reviewed. In drafting the guideline, data assessments and opinions by authoritative scientific bodies providing guidance on the safety of flavan-3-ols were considered. Moderate evidence supporting cardiometabolic protection resulting from flavan-3-ol intake in the range of 400-600 mg/d was supported in the literature. Further, increasing consumption of dietary flavan-3-ols may help improve blood pressure, cholesterol levels, and blood sugar. Strength of evidence was strongest for some biomarkers (i.e., systolic blood pressure, total cholesterol, HDL-cholesterol, and insulin/glucose dynamics). It should be noted that this is a food-based guideline and not a recommendation for flavan-3-ol supplements. This guideline was based on beneficial effects observed across a range of disease biomarkers and endpoints. While a comprehensive assessment of available data has been reviewed, evidence gaps identified herein can inform scientists whereby guiding future randomized clinical trials.

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“…The remaining five (63%) of diet and lifestyle-based interventions did not associate with placental changes (Figure 8) [31, 82-85].…”

Section: Resultsmentioning

confidence: 99%

Do nutritional interventions before or during pregnancy affect placental phenotype? Findings from a systematic review of human clinical trials

Bonnell,

White,

Connor

2024

Preprint

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Background: Maternal nutritional interventions aim to address nutrient deficiencies and improve maternal, fetal, and pregnancy outcomes. However, the effects of these interventions on the placenta are not well known, which is a major gap in understanding how such interventions could influence pregnancy outcomes and fetal health. We hypothesised that nutritional interventions influence placental phenotype, and that these placental changes relate to how successful, or not, the intervention is in improving pregnancy outcomes. Methods: We conducted a systematic review and followed PRISMA-2020 reporting guidelines. Articles were retrieved from PubMed, Clinicaltrials.gov, and ICTRP-WHO using pre-defined search terms and screened by two reviewers using a 3-level process. Inclusion criteria considered articles published from January 2001-September 2021 that reported on clinical trials in humans, which administered a maternal nutritional intervention during the periconceptional or pregnancy period and reported on placental phenotype (histomorphometry, function or placental disorders). Findings: Fifty-three eligible articles reported on (multiple) micronutrient- (n=33 studies), lipid- (n=11), protein- (n=2), and diet-/lifestyle-based (n=8) interventions. Of the micronutrient-based interventions, 16 (48%) associated with altered placental function, namely altered nutrient transport/metabolism (n=9). Nine (82%) of the lipid-based interventions associated with altered placental phenotype, including elevated placental fatty acid levels (n=5), altered nutrient transport/metabolism gene expression (n=4), and decreased inflammatory biomarkers (n=2). Of the protein-based interventions, two (66%) associated with altered placental phenotype, including increased cerebro-placental ratio (n=1) or decreased preeclampsia risk (n=1). Three (38%) of diet and lifestyle-based interventions associated with altered placental phenotype, namely placental gene expression (n=1) and disease (n=2). In studies with data on maternal (n=30) or offspring (n=20) outcomes, interventions that influenced placental phenotype were more likely to have also associated with improved maternal outcomes (11/16 [69%]) and offspring birth outcomes (6/11 [54%]), compared to interventions that did not associate with placental changes (2/15 [13%] and 1/9 [11%], respectively). Conclusions: Periconceptional and prenatal nutritional interventions to improve maternal/pregnancy health associate with altered placental development and function. These placental adaptations likely benefit the pregnancy and improve offspring outcomes. Understanding the placenta's role in the success of interventions to combat nutrient deficiencies is critical for improving interventions and reducing maternal and neonatal morbidity and mortality globally.

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High-flavanol and high-theobromine versus low-flavanol and low-theobromine chocolate to improve uterine artery pulsatility index: a double blind randomized clinical trial

Cited by 7 publications

References 24 publications

Nanoparticle-Mediated Simultaneous Downregulation of Placental Nrf2 and sFlt1 Improves Maternal and Fetal Outcomes in a Preeclampsia Mouse Model

Nanoparticle-Mediated Simultaneous Downregulation of Placental Nrf2 and sFlt1 Improves Maternal and Fetal Outcomes in a Preeclampsia Mouse Model

Flavan-3-ols and Cardiometabolic Health: First Ever Dietary Bioactive Guideline

Do nutritional interventions before or during pregnancy affect placental phenotype? Findings from a systematic review of human clinical trials

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